Gastroenterologists are intermittently involved in diagnosing and managing patients who have neuroendocrine tumours (NETs). However, few UK gastroenterologists have received extensive training about this topic. This article aims to provide a brief introduction to NETs; it is aimed at a general gastroenterologist audience.
NETs present in diverse ways and many symptomatic patients unfortunately experience significant delays in diagnosis. Comprehensive evaluation of a patient with a possible NET involves assessing their symptoms, the tumour’s primary organ of origin, its differentiation status, grade and stage, whether the NET is secreting hormones and whether there is any underlying hereditary predisposition. Such assessment often needs specialist investigations such as nuclear medicine scans. All these factors influence patient management and prognosis, so a patient’s case and investigations should always be discussed by a fully constituted NET multidisciplinary team. Most localised tumours are considered for resection, but there are multiple treatment options for metastatic disease and many patients receive several different therapies during the course of their illness. The most common first line treatment in patients who have metastatic low grade NETs is monthly long acting somatostatin analogue injections. Prognosis is highly variable, but some patients who have inoperable metastases survive for many years on treatment with good quality of life. Gastroenterologists may also be involved in managing the non-tumour associated chronic gastrointestinal problems that some patients experience. Their involvement has been shown to improve patient-reported outcomes and quality of life.
- gastrointestinal neoplasia
- gut hormones
- gastrointestinal cancer
- small bowel disease
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Twitter @DrMohidKhan, @gastrolivuni
Contributors MSK and DMP both wrote sections of the first draft of this review and both revised the final article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests DMP has received consultancy funding from Ipsen, Advanced Accelerator Applications and Mayoly Spindler laboratories and research funding to investigate gastric NETs from Trio Medicines. MSK has received consultancy and speaker fees from Ipsen,Advanced Accelerator Applications and Novartis.
Patient consent for publication Not required.
Provenance and peer review Commissioned; externally peer reviewed.
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